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How Robotic Surgery Done in Rectal Cancer ?

Can Robotic Surgery Be Done for Rectal Cancer? A Comprehensive Overview

Rectal cancer is a condition that impacts a lot of patients every year. There are numerous treatment options, including surgery for rectal cancer.

In this blog, we will discuss the possibility and benefits of using robotic surgery for treating rectal cancer. With the rising incidence of rectal cancer in India and around the world, it is crucial to understand how advanced surgical techniques like robotic surgery can be beneficial in the management of this disease. But first, let’s understand the rectum and its function in our body.

Understanding the Rectum

The rectum is the last part of the large intestine, located just above the anus. Its primary function is to store stool and release it at the appropriate time. Rectal cancer, which is increasingly common in India, occurs in this part of the digestive system.

The rectum is deeply situated in the pelvic cavity, making it difficult to access during surgery. The anatomy of the rectum is divided into three parts: upper, middle, and lower. The middle and lower parts of the rectum contain the sphincter muscle, which is responsible for waste control and managing stool sensation. In cases where the cancer is near the sphincter, surgical removal of the muscle might be necessary, which could result in the patient requiring a permanent colostomy bag.

Role of Robotic Surgery in Rectal Cancer Treatment

Robotic surgery is a minimally invasive, or keyhole, surgery technique that uses a robot to replicate the surgeon’s movements. The surgeon fully controls the robot, and it does not perform surgery on its own. Robotic surgery offers several advantages for rectal cancer treatment:

• Access to deep and inaccessible locations: Robotic instruments are longer than those used in laparoscopy, making it easier for the surgeon to reach difficult areas. The robot’s endo wrist facility allows it to mimic the exact movements of the surgeon’s hand in a narrow space. The small diameter (8mm) of these instruments enables them to easily reach confined locations.
• Magnified vision: Robotic surgery provides 10 to 12 times magnification and a 3D vision, enabling the surgeon to see internal organs or regions in or near the rectum clearly. This improved visualization helps the surgeon protect healthy tissue and remove only the cancerous parts.

• Reduced Risk compared to laparoscopy: Laparoscopy and open surgery carry risks for rectal organs, as the rectum is closely associated with other organs, such as the bladder, seminal vesicles, and urethra, which are essential for sexual function. There is also a chance of injuring nerves during these procedures. However, robotic surgery makes it easier to identify and protect these nerves, reducing the risk of injury.
• Lower conversion rate: Laparoscopy in rectal cancer cases sometimes needs to be converted into open surgery due to complexities. However, robotic surgery reduces the chances of conversion, making the procedure more straightforward.

Moreover, the sphincter muscle can often be preserved with robotic surgery. Studies indicate that robotic surgery may be a better option than laparoscopy in some cases.